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Care During Labour, Childbirth, and Immediate Newborn Care in India: A Review

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Abstract

India is committed to achieve a single-digit neonatal mortality rate (NMR) and stillbirth rate (SBR) by 2030 through India Newborn Action Plan (INAP) 2014. However, the current rate of decline is not enough to achieve the target neonatal mortality rate. Course correction and renewed efforts are required. This review outlines the current scenario and proposed scale-up of services included during labour, childbirth, and the immediate newborn period. The article summarises the challenges and bottlenecks in achieving a reduction in neonatal mortality rate and INAP targets. India has achieved over 80% coverage of three of the four ENAP coverage targets, but antenatal care coverage is still poor. There are concerns about the quality and completeness of antenatal care visits and other program interventions. The ongoing quality assurance should be strengthened through continuous supportive supervision by involving the medical colleges in a hub and spoke model and other key stakeholders. There is a need for effective and strategic engagement of the private sector in these initiatives. The states need to systematically assess the gaps as per population requirements and find effective solutions to overcome them quickly. The state and district-wise data maps show immense variations in coverage between states and within states, mirroring the variations in NMR. This indicates the need to ensure contextual micro-plans and provides an opportunity for the districts and states to learn from each other. The recent initiatives to strengthen primary healthcare should be used as a platform for all stillbirth and neonatal mortality prevention interventions in India.

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Acknowledgements

The authors would like to thank Dr. Chandrakant Lahariya, Dr. Rodney P Vaz, and other technical staff at the Integrated Department of Health Policy, Epidemiology, Pediatrics and Preventive Medicine at the Foundation for People-centric Health Systems for reviewing and providing input on the earlier version of this manuscript.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Chandigarh, India

    Jogender Kumar, Shiv Sajan Saini & Praveen Kumar

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  1. Jogender Kumar
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  2. Shiv Sajan Saini
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  3. Praveen Kumar
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PK conceived the idea and outline, and critically reviewed, revised and finalized the manuscript; JK and SSS wrote parts of the initial draft and revised as per feedback. PK will act as the guarantor for this manuscript.

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Correspondence to Praveen Kumar.

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Kumar, J., Saini, S.S. & Kumar, P. Care During Labour, Childbirth, and Immediate Newborn Care in India: A Review. Indian J Pediatr 90 (Suppl 1), 20–28 (2023). https://doi.org/10.1007/s12098-023-04721-7

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